Healthcare Provider Details

I. General information

NPI: 1689553505
Provider Name (Legal Business Name): AARON HICKS PA-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/27/2025
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

779 KRISTINE WAY
THE VILLAGES FL
32163-0099
US

IV. Provider business mailing address

9848 CRESCENT RAY DR
WESLEY CHAPEL FL
33545-4939
US

V. Phone/Fax

Practice location:
  • Phone: 844-884-9355
  • Fax: 352-674-6030
Mailing address:
  • Phone: 919-609-2915
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA9120618
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207QA0505X
TaxonomyAdult Medicine Physician
License Number9120618
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: